‘War scene’: How Orlando surgeons fought to save shooter’s victims

The call came in not long after the shooting started. Not long after 2 a.m.

Just three blocks away — as it turns out, a life-saving distance — a killer was shooting his way through a popular nightclub packed with club-goers in what would become the nation’s deadliest attack by a lone gunman. After the pandemonium of bullets ringing above music, of screams, of bodies falling, the wounded began to arrive at Orlando Regional Medical Center, the area’s only level one trauma center.

“We didn’t know exactly how many we were going to get. Our first patient was relatively stable, awake and talking to us and, we thought maybe they are going to be like this. And then we quickly got two or three more that were very critical in nature,” said Dr. Kathryn Bondani, who was working the overnight shift. “We got five patients...and thought maybe that will be it. And then they quickly started lining up in the hallway. They were being dropped off in truckloads.”

Within half an hour, a trauma center normally equipped for a busy but typical Saturday night, maybe five or six gunshot wound victims, was suddenly mobbed — with people in every corner suffering bullet wounds, with doctors and nurses who had rushed from home, with first-responders and citizens bringing in more of the wounded over a two-hour stretch. Those hurt were suffering small- and large-caliber wounds, tissue shredded, cavities shattered, on a scale like nothing the medical staff had ever seen.

Like a “war scene” is how Dr. Joseph Ibrahim described the harrowing aftermath of Sunday’s massacre.

In all, 49 people were killed, plus gunman Omar Mateen; 44 of the wounded were treated at the trauma center, among the busiest in Florida. Of that number, nine died at the hospital early on, but none since then. Twenty-seven remain in the hospital, with six in intensive care. And two of the six, are “profoundly ill.”

As the victim after victim arrived, Dr. Chadwick Smith, the attending trauma surgeon that night, began urgently calling for backup. “I said, this is not a drill, this is not a joke. We have 20-plus gunshot wounds coming in. I need you here as fast as you can,” he said, his voice thinning as he described the scene. “We had people in pain, people worrying about their loved ones, people not knowing where their loved ones were and we are trying to help them all.’’

Among the wounded: Angel Colon, who was in Pulse nightclub saying farewell to friends when the shots began.

First he heard them. Then he felt them.

Three quick shots to his leg and the instinct to run propelled him forward, then face-down on the floor. What he didn’t know at the time: Mateen was not finished.

“We grabbed each other and started running. Unfortunately, I was shot three times in my leg and I had fallen,” Colon shared at a hospital news conference. “I got trampled over. I shattered and broke bones in my left leg.”

As Colon lay wounded, Mateen returned, shooting the woman beside Colon. He was next.

“I hear him coming back. He is shooting everyone that’s already dead on the floor, making sure they are dead,” Colon, 26, said tearfully while in a wheelchair and flanked by his five siblings and the trauma medical team that handled the victims. “I am thinking, ‘I am next. I am dead.’ ”

Colon said Mateen took aim. He shot toward Colon’s head, hitting him in the hand. Then another shot struck him on the side of his hip.

“I had no reaction. I was preparing to stay there, laying so he would not know that I am alive,” Colon said. Moments later, a police officer grabbed Colon’s hand. He apologized and said, “This is the only way I can get you out of here.”

Colon said the police officer dragged him across broken glass on the club floor, across the street to the parking lot of a fast food restaurant, where he joined other shooting victims. “I looked over and there’s just bodies everywhere. We are all in pain.”

At a news conference Tuesday afternoon at Florida Hospital Orlando, two more survivors, Angel Santiago and Patience Carter, shared their stories. The hospital’s emergency department treated 12 patients, six of whom remain hospitalized, all in fair condition.

Orlando Regional Medical Center had already developed a multi-tiered strategy for responding to a disaster, much of it built on lessons learned from the 2004 hurricane season. But nothing could have prepared them for Sunday’s early-morning rampage.

Back at the hospital that night, a beefed-up staff, including some from nearby medical centers, had to make quick assessments, based on vital signs, wound severity and pattern, to determine who most needed emergency surgery. They focused on the most critically injured and moved others to another part of the hospital. Because Mateen was armed with an AR-15 semiautomatic rifle and a handgun, the wounds were extensive.

“We saw the full gamut of wounds, from wounds to the extremities to wounds to the chest, wounds to the abdomen and pelvic areas. Small caliber and very large caliber,” said Ibrahim. “The large calibers left a significant amount of tissue destruction.’’

Dr. William Havron, a trauma surgeon, remembers walking into the hospital, calling it surreal.

“We were just given patient after patient after patient,” Havron said. “We’d literally walk from that operation room to another operating room and just do it again and again.”

At one point, all six trauma bays were in use. Doctors operated, then workers made way for the next patient, cleaning up in 30 to 45 seconds, removing “sharp objects, bloody towels and all kinds of stuff,” Smith said.

“After we got that initial wave of about 20 to 22 patients stabilized,” he recalled, “we had a kind of a lull while the shooter was barricaded inside.”

Then came another crush of wounded club-goers, about 3:30 a.m., 90 minutes after that first patient arrived.

“We basically had a repeat of the first wave,’’ Smith said.

The trauma team performed its 13th procedure at 6 a.m.